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She said it “has become clear that we will not be able to achieve our $65.9 million (3.3%) budgeted operating margin” for fiscal year 2020.

Because most elective procedures and routine appointments have been postponed, patient service revenue is dropping to the extent that D-H may rely on a line of credit to provide some financial flexibility, she said.

D-H also has “modeled the impact of the anticipated surge” and found that revenue from COVID-19 patients “will not offset the lost revenue” from the procedures D-H has deferred, she wrote.

Conroy also noted that despite the steep drop on Wall Street, health care “generally” continues to grow, even during a recession, so DHMC plans to move forward with plans for a new $130 million, 112-bed patient tower, though the CEO cautioned, “we may need to consider some delay in the groundbreaking.”

Other hospital systems have already tightened their belts. In the Boston area, the Beth Israel Deaconess Medical Center physicians’ group suspended employer contributions to its retirement plan, and South Shore Health deferred pay increases to nurses, The Boston Globe reported.

Meanwhile, Dartmouth College warned of changes to come in a community-wide email Friday morning from President Phil Hanlon.

Citing predictions of skyrocketing unemployment and a steep fall in gross domestic product, Hanlon said “the consequences of this downturn will be felt in many ways,” including strain on students’ families and on local businesses.

Hanlon said Dartmouth is losing $15 million in undergraduate room and board revenue this spring since students have been told not to return to campus, and alumni donations will also be affected. More to the point, the steep drop in the stock market has hit the endowment and “will impact an important revenue stream for Dartmouth now and into the future,” though he gave no specific numbers.

Hanlon’s email said Dartmouth has “taken steps to prepare for an economic downturn”; has strong liquidity; and has “built up reserve funds to cushion the immediate impacts of a recession.”

Nonetheless, he warned, “the magnitude of the financial shock will require us to take additional steps to meet the immediate financial challenges we are facing,” with details to be announced in the coming weeks.

Woodstock tellssecond-homeownersto self-quarantine

Woodstock emergency management officials are asking second-homeowners from the New York metro area to stay in their homes for 14 days if they come to town, citing Centers for Disease Control and Prevention guidelines.

“We understand that many of our second homeowners permanently reside in the greater New York City area, which is now the epicenter of the COVID-19 virus,” Police Chief Robbie Blish and Fire Chief David Green said in an email to second-homeowners and full-time residents.

“If you have recently been in the greater NYC area and are now residing in the Town/Village of Woodstock we request that you please self-quarantine for a period of 14 days, as recommended by the CDC.”

“We welcome you to Woodstock and pledge to you that Woodstock and Vermont are prepared to respond to the COVID-19 virus,” they added.

Their message reinforced the “Stay Home, Stay Safe” order issued earlier this week by Vermont Gov. Phil Scott, which is in effect until at least April 15.

Emma Schmell, rental agent for Williamson Group Sotheby’s International Realty in Woodstock, said she’s hearing from people in the Boston and New York areas, asking if “something is available for one, two or three months.”

“There’s definitely been an increase in inquiries about immediate short-term rentals,” she said.

As of Wednesday, she hadn’t made any matches. Only about a half-dozen properties are available in the Woodstock area. “Inventory is scarce,” she said.

March and April — mud season — “traditionally are an undesirable time to be here.”

Time to Quit

Vermont Health Commissioner Mark Levine urged Vermonters who smoke cigarettes or vape to use the time they may now have at home to quit. Smoking and vaping can cause damage to people’s lungs, making it more difficult for them to fight off COVID-19, he said.

There’s “never been a better time (or) reason to quit,” Levine said during a Friday news conference.

He encouraged Vermonters in need of support to quit to call 1-800-QUIT-NOW or to visit 802quits.org. The state also launched a new website to support those in recovery from alcohol and drug addictions, vthelplink.org.

Levine also announced two more deaths in Vermont due to the virus, bringing the state’s total to 10. Seven of those have been tied to Burlington Health & Rehab, where an outbreak is ongoing. The state had a total of 184 cases, including 18 in Windsor County and three in Orange County, as of Friday afternoon.

In New Hampshire, at least 33 of the 187 cases thus far are health care workers. The state’s cases included 26 in Grafton County and two in Sullivan County. There have so far been 30 hospitalizations and two deaths due to COVID-19 in New Hampshire.

More testing in Vt.

As part of the state’s effort to further reduce transmission, it is rolling out a new protocol to allow for testing of patients with mild and moderate symptoms, Levine said.

He encouraged patients who may not have previously qualified for testing to call their health care providers to see if they now qualify. Those without symptoms still will not be tested and patients are discouraged from showing up for testing without calling ahead.

As part of this effort, the state is deploying more contact tracing teams and “aggressive procurement strategies” for the collection and testing supplies needed to make this effort possible.

“In the end, we may need the federal government to assist us with materials,” he said.

Educators adjust

Vermont educators are working to put together plans for how education will look through the end of the school year, Secretary of Education Dan French said in the news conference, which came the day after Gov. Phil Scott issued an order extending the closing of schools and child care centers.

French said extending the closings was the right move.

“As difficult as this is (it) provides some stability (and) gives us the ability to innovate,” he said.

While the Agency of Education is not making any recommendations related to changes in staffing at this time, French said districts will be evaluating their staffing as they further adjust to remote learning. They should know more by the middle of next month, when districts are required to file plans with the state.

In New Hampshire, Gov. Chris Sununu on Thursday extended “remote learning” for schoolchildren through at least May 4, meaning thousands of students in the Granite State will remain at home for five more weeks.

CRREL employee tests positive for COVID-19

A U.S. Army Engineer Research and Development Center employee assigned to the Cold Regions Research and Engineering Laboratory in Hanover tested positive for COVID-19, according to news release from CRREL.

The employee is in quarantine at home. Other people who came into contact with the infected employee have been notified, the release said.

Access to CRREL and other similar research facilities across the country is restricted to mission-critical personnel and essential services contractors.

Gun shops askto be ‘essential’

The Gun Owners of Vermont sent Scott a letter urging him to add federal firearm license dealers to the list of businesses considered “essential” during the COVID-19 crisis.

“As I’m sure you are aware, many residents have chosen to purchase a firearm for protection during this time of uncertainty and Article 16 of the Vermont Constitution guarantees them that right,” said Eric Davis, the group’s president, in the letter.

D-H closes Lyme clinic

Dartmouth-Hitchcock closed its Lyme clinic on Thursday as part of the Lebanon-based health system’s effort to consolidate resources to respond to COVID-19.

“This decision was not made lightly, but we believe given the circumstances in not only our town and region, but nationally, this is the right decision for the care and safety of our patients and employees,” Dr. Kent Powell, the clinic’s leader, said in a Thursday email to the Lyme clinic community that was posted to the Lyme Listserv.

Patients in Lyme will continue to be served through telehealth visits, but the clinic will not be offering laboratory services or in-person visits. People who need in-person treatment will be referred to Dartmouth-Hitchcock Medical Center’s internal medicine clinic.

The clinic plans to reopen after the COVID-19 crisis, Powell said.

Child care foressential workers

Hanover Parks and Recreation is working with Dartmouth-Hitchcock Medical Center to match child care providers with essential medical personnel.

The Rec Department has created an online form for those interested in providing care to families in their homes. It is sharing information with DHMC that will be used to match the caregivers with families. Care will be provided in families’ homes and compensation will be worked out between the families and caregivers.

The web form is online at hanoverrec.com.

Protecting newborns

In order to protect newborns from COVID-19, Dartmouth-Hitchcock Medical Center and other hospitals are following the CDC’s recommendations to separate the mother and baby after birth if the mother is infected or suspected of having the infection.

“While this is an incredibly emotional and difficult step to take, it is the right thing for the health of the baby,” D-H said in a news release on Thursday.